Adherence to ART in PLWHA and Yirgalem Hospital, South Ethiopia

Background: Non-adherence to Antiretroviral Therapy is a major challenge to AIDS care, and the risks associated with it are extensive. Objective: To assess factors associated with non-adherence among AIDS patients receiving Antiretroviral Therapy at Yirgalem Hospital, Southern Ethiopia. Method: A comparative cross sectional survey was carried out at Yirgalem Hospital between July 10 and August 30, 2006. The two-proportion formula for unmatched case control study with 1:3 ratio was used to calculate the sample size. Systematic sampling was used to recruit patients. Using a structured and pre-tested questionnaire, data on drug adherence were collected through interview and pill count. Non-adherent patients were compared with adherent patients and associations with key risk factors were determined. Results: Two hundred and ninety one AIDS patients were involved in the survey. Prevalence of adherence in the week before interview was 74.2%. Main reasons of non-adherence cited by the patients were; being busy or simply forgetting (51%), change in daily routine (9.4%), and being away from home (8.3%). Non-adherence was commoner among patients reporting symptoms in the past four weeks (Adj. OR=6.41, 95% CI: 2.41 to 17.08), who lived more than 47 km away (AOR= 2.48, 95%CI: 1.24 to 4.98), or who had dependents (Adj. OR=1.95, 95%CI: 1.06 to 3.57). Conclusions: Efforts must be made to make the service accessible by commencement of ART service in more Health Centers; to improve patients' awareness of ARV adverse effects; and to provide social support to all People Living with HIV, particularly those who have dependents. (Ethiop.J.Health Dev. 2008;22 (2):174-179)